Antenatal corticosteroids GTG Flashcards
When should antenatal corticosteroids be offered to women?
Antenatal corticosteroids should be offered to women between 24+0 and 34+6 weeks of gestation when imminent preterm birth is anticipated.
Should antenatal corticosteroids be offered to women with multiple pregnancies?
Yes, women with twins and triplets should be offered targeted antenatal corticosteroids in line with the recommendations for singletons.
What is the benefit of administering antenatal corticosteroids within 48 hours before preterm birth?
Administering antenatal corticosteroids within 48 hours before preterm birth reduces neonatal death and significantly decreases the risk of respiratory distress syndrome (RDS).
What is the effect of antenatal corticosteroids when given within 7 days before preterm birth?
A course of antenatal corticosteroids given within 7 days before preterm birth reduces perinatal and neonatal death as well as the incidence of respiratory distress syndrome.
What risks are infants born via cesarean section (CS) more likely to face?
Infants born via cesarean section (CS) are at a higher risk of respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), and need for neonatal intensive care unit (NICU) admission.
What is the risk of respiratory morbidity in infants born at term?
The risk of respiratory morbidity in infants born at term is low (around 5%) and decreases with advancing gestational age.
Should corticosteroids be given for planned CS before 39 weeks?
Antenatal corticosteroids may be considered for planned cesarean section before 39 weeks to reduce respiratory morbidity, but the evidence is inconclusive. The potential benefits should be discussed with the woman.
What are the potential risks of antenatal corticosteroids in late pregnancy?
Steroids in late pregnancy may increase the risk of neonatal hypoglycemia in term neonates and may be associated with developmental delay, though the data on this is limited.
What are the benefits of antenatal corticosteroids for women between 22+0 and 34+6 weeks?
Antenatal corticosteroids in this gestational age group are highly likely to reduce perinatal mortality, neonatal death, and neonatal respiratory distress. They are also likely to reduce intraventricular hemorrhage and developmental delay in childhood. However, they may reduce birthweight if given more than 7 days prior to birth.
What are the potential long-term effects of antenatal corticosteroids on children born at term?
Antenatal corticosteroids may increase the risk of psychiatric and behavioral diagnoses in children born at term. However, the evidence is not conclusive.
What is the impact of antenatal corticosteroids for pregnancies between 35+0 and 36+6 weeks?
For pregnancies between 35+0 and 36+6 weeks, antenatal corticosteroids are likely to reduce the need for respiratory support, but they may increase the risk of neonatal hypoglycemia.
What are the potential benefits of corticosteroids before a planned cesarean section at term (37-39 weeks)?
For planned cesarean sections at term (37-39 weeks), corticosteroids may reduce admission to the neonatal unit (NNU) and potentially reduce educational attainment deficits at school age.
How does diabetes affect the use of antenatal corticosteroids?
Women with diabetes may require additional insulin and monitoring when receiving antenatal corticosteroids. Maternal blood glucose can rise shortly after steroid administration and may remain elevated for up to 5 days.
What is the typical dosage of antenatal corticosteroids?
The typical dosage is either:
- Two doses of 12 mg dexamethasone intramuscularly (IM) 24 hours apart, or
- Four doses of 6 mg dexamethasone IM 12 hours apart. Alternatively, two doses of 12 mg betamethasone IM 24 hours apart can be used, though there is limited evidence on this regimen.
When are antenatal corticosteroids most effective?
Antenatal corticosteroids are most effective when the first dose is given within 48 hours prior to birth. Benefits are also seen when the first dose is given within 24 hours of birth.
